重症胆源性胰腺炎早期内镜治疗的临床对照研究  

Clinical control study of early endoscopic therapy for severe gallstone pancreatitis

作　　者：费凛[1] 

机构地区：[1]佛山市第一人民医院胆道外科,广东佛山528000

出　　处：《胃肠病学和肝病学杂志》2016年第8期903-905,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：广东省医学科学技术研究基金项目(A2011588)

摘　　要：目的探讨重症胆源性胰腺炎早期内镜治疗的临床价值。方法采用前瞻性随机对照研究,纳入佛山市第一人民医院2011年9月-2014年11月收治的确诊为重症胆源性胰腺炎患者共100例,所有病例均在发病72 h内接受治疗,其中非手术治疗组采用常规对症内科治疗,包括胃肠减压、灌肠、肠内营养、腹腔穿刺引流等方法;内镜治疗组则在非手术治疗组的基础上进行内镜下治疗。观察两组患者1周内的APACHE-Ⅱ和Balthazar CT评分,同时记录并发症和死亡率。结果入院治疗后第3天开始,内镜治疗组的APACHE-Ⅱ评分低于非手术治疗组,两组相比差异有统计学意义(P<0.05);入院后第7天内镜治疗组Balthazar评分低于非手术治疗组,两组相比差异有统计学意义(P<0.05),内镜治疗组并发症和死亡率低于非手术治疗组,差异有统计学意义(P<0.05)。结论早期内镜治疗与非手术治疗相比可以降低重症胆源性胰腺炎的并发症及死亡率,是治疗急性胆源性合并胆管梗阻的有效方法之一。Objective To investigate clinical value of early endoscopic therapy for severe gallstone pancreatitis. Methods A total of 100 patients with severe gallstone pancreatitis in the Foshan City First People＇s Hospital from Sep. 2011 to Nov. 2014 were collected by the prospective randomized controlled method. All patients received treatment within 72 hours of the onset,including non-surgical treatment group with conventional medical treatment（ gastrointestinal decompression,enema,not for endoscopic treatment）; endoscopic treatment group with endoscopic therapy on the basis of conventional medical treatment. APACHEⅡand Balthazar CT scores were observed in two groups within 1 week. At the same time,the incidences of complications and death were recorded. Results Since the 3rd day after admission,APACHE Ⅱscore in endoscopic treatment group was lower than that in non-surgical treatment group（ P〈 0. 05）; At the 7th day after admission,Balthazar CT examination score in endoscopic treatment group was lower than that in non-surgical treatment group（ P〈 0. 05）; the incidences of complications and death in endoscopic treatment group were lower than those in non-surgical treatment group（ P 〈0. 05）. Conclusion Early endoscopic therapy can reduce complications and mortality of severe deformity of gallstone pancreatitis,it is the effective method for theating biliopancreatic obstruction.

关 键 词：重症胆源性胰腺炎 早期内镜下治疗 早期非手术治疗 临床价值 

分 类 号：R576[医药卫生—消化系统]